Transgender and gender diverse youths' experiences of healthcare: A systematic review of qualitative studies.

This is a qualitative evidence synthesis, so it reports experiences and recommendations, not measured clinical outcomes or treatment effects. The review included 16 studies and 286 youths, and almost half did not report researcher positionality. Most included studies were from high-income countries with majority Caucasian populations, so experiences of transgender and gender diverse youths in lower-income countries or indigenous or minority racial groups may not be represented. Gender specialist services, mental health services and primary care were overrepresented, so findings may not apply to other healthcare settings. The search was limited to seven databases, English language and January 2016 to July 2022, with no grey literature. Some included studies aimed to capture transgender and gender diverse youth and parent experiences but underrepresented youths in their results.

The authors declared no potential conflicts of interest. The research was funded through a PhD scholarship by the Catherine McAuley School of Nursing & Midwifery, University College Cork, Ireland.

Do not read this review as proof that gender-affirming medical interventions improve mental health outcomes for all transgender and gender diverse youths. The included studies were qualitative and reported participants' experiences, including side effects and appointment burdens, so they do not establish efficacy or safety.